Spinal Cord Injury
[Credit: Texas family, photo by christie stockstill (pho.tog.ra.phy)]
Spinal cord injury (SCI) resulting from accidents, gunshots or other traumas is a tragedy that affects hundreds of thousands of people of all ages. Vehicular accidents cause about 44% of these injuries. Nearly one-quarter are the result of violence and 22% are the result of falls. Sports injuries account for 7% of spinal cord injuries. The remaining 1% of spinal cord injuries results from work-related or other accidents.
Many SCI victims tend to be young adults and most are male. About 53% of spinal cord injuries occur among persons in the 16 to 30 year age group. Overall, 81% of all persons suffering form spinal cord injuries are male.
Spinal cord injuries involve the damage and destruction of nerve fibers within the spinal cord, a central component of the communication system our brains use to direct the functioning of our bodies. Breaks in this communication system lead to paralysis and diminished or absent control of basic body functions.
Paraplegia (losses of movement and sensation in the lower body) affects 47% of the SCI population and 52% are affected by quadriplegia (losses of movement and sensation in both the arms and legs).
Human and Social Costs
According to a study initiated by the Christopher & Dana Reeve Foundation, there are nearly 1 in 50 people living with paralysis — approximately 6 million people. That’s the same number of people as the combined populations of Los Angeles, Philadelphia, and Washington, D.C. And that number is nearly 33% higher than previous estimates showed.
- Spinal cord injuries cost the nation at least $9.7 billion per year for medical care, equipment and disability support.
- Trauma and rehabilitation costs alone are almost $250,000 for each SCI patient.
- Because spinal cord injuries happen predominantly to people under the age of 30, the human cost is high. Additional lifetime costs incurred by SCI individuals average $400,000 and can reach as high as $2.1 million depending on the extent of injury.
As with other devastating diseases and injuries, the emotional costs to SCI sufferers and their families are extremely high and cannot be quantified in terms of dollars and cents.
Potential for Cures
Advances in research are giving doctors and patients hope that repairing injured spinal cords is a reachable goal. Considering the biological complexity of spinal cord injury, discovering successful ways to repair injuries is not an easy task. The advances in basic research are being matched by progress in clinical research and although much additional research is still needed to determine if this hope can be turned into a reality– the potential is clear.
The National Institute of Neurological Disorders and Stroke (NINDS) conducts spinal cord research in its laboratories at the National Institutes of Health (NIH) and also supports additional research through grants to major research institutions across the country. Most of their clinical research progress has given us a better understanding of the kinds of physical rehabilitation that work best to restore function. Some of the more promising rehabilitation techniques are helping spinal cord injury patients become more mobile.
The advances in rehabilitation techniques are very important and critical to curing a spinal cord injury. Because traumatic injury to the adult spinal cord results in a massive loss of cells and permanent functional deficits, a potential therapeutic strategy involves replacing cells as well. Cell therapies could provide potential benefit by replacing lost neurons, promoting regeneration of existing neurons, and filling in the spinal cord cavity to minimize further damage and inflammation. A variety of cell types are under investigation.
Studies have demonstrated cells may prove to be an important new therapeutic target to improve recovery after injury to the spinal cord and brain. Various animal studies conducted in recent years indicate that cell transplants could be used to repair and regrow spinal cord nerve fibers and could someday allow SCI victims to walk again.
Although it will take years of additional research to determine if any cell therapies can lead to similar results in humans, the consensus of the medical and patient community is that all types of stem cell research should be pursued in the effort to find a way to repair spinal cord injuries.
Stem cell research is strongly supported by the overwhelming majority of medical researchers; medical organizations, including the American Medical Association; and disease and patient advocacy groups like the Christopher Reeve Paralysis Foundation, National Council on Spinal Cord Injury, Daniel Heumann Fund for Spinal Cord Research, Research for Cure of Spinal Cord Injury, United Spinal Association, The Miami Project to Cure Paralysis, Cure Paralysis Now, and The Roman Reed Foundation.
In September 2011, a patient in San Jose, Calif., became the fourth person to be treated with embryonic stem cells in an FDA-approved clinical trial for patients with a spinal cord injury. Developed by Geron Corp. of Menlo Park, the treatment has been shown to restore limb function in rats. In this first phase of the clinical trial process, researchers will review the therapy’s safety. Later they will consider its effectiveness. (San Jose Mercury News, Sept. 20, 2011)